Fix-Auto Swansea Tour of Epynt 2010 Internet Entry Form

Entries to this event are now closed and this page is for record only

Entries Close for seeding on Monday 8th March 2010

Entries Secretary:

Mr Robert Wilson 
35 Heol Eglwys
Ystradgynlais
swansea
SA9 1EY
Telephone 01639 849413
e-mail: wilsonrobbie@hotmail.co.uk

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FISA) and the Supplementary Regulations

Welcome to Fix-Auto Swansea Tour of Epynt 2010 Online Entry system. Please follow the steps below to enter the rally.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory.
  2. Once you have hit the "Enter the Rally" button at the end you will receive an automated response confirming we have received your entry form.
  3. There are then two ways to pay
    1.  If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank Barclays
      Sort Code 20-84-41
      Account No. 40750743
      Account Name Port Talbot Motor Club Ltd     
      Reference Driver's full name.
    2. You can send a cheque made payable to 'Port Talbot Motor Club Ltd' to the Entries Secretary at the address above.
  4. Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  5. If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail wilsonrobbie@hotmail.co.uk

All the fields with a red background must be filled in, or you will not be able to continue. Please put TBA in any red field which you do not know the details for.

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to? DriverCo-Driver
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Phone Number
Competition Licence Number
E-Mail Address
Club
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Phone Number
Competition Licence Number
E-Mail Address
Club
Car
Make
Model
Colour
Registration Number
Engine Capacity
Forced InductionNo
Yes
Four Wheel DriveNo
Yes
Class - Cars conforming to FIA Group N regulations
N1 - Up to and including 1400cc
N2 - Over 1400cc up to and including 1600cc
N3 - Over 1600cc up to and including 2000cc
N4 - Over 2000cc
- Cars conforming to FIA Group A regulations
A5 - Up to and including 1400cc
A6 - Over 1400cc up to and including 1600cc
A7 - Over 1600cc up to and including 2000cc
A8 - Over 2000cc
- Cars complying with the 2010 MSA technical Regulations
B9 - Up to and including 1400cc
B10 - Over 1400cc up to and including 1600cc
B11 - Over 1600cc up to and including 2000cc
B12 - Over 2000cc 2 wheel drive
B13 - Over 2000cc 4 wheel drive
B14 - Any 4 wheel drive current or former WRC or derived from one
15 - Road Rally Cars - as per welsh Tarmacadam rules 2010
Insurers
Name
Address

Service vehicle description

Make
Model
Colour
Registration Number
Contact Name
Contact Number

Championships

The ANWCC Rally ChampionshipNo
Driver Only
Co-Driver Only
Both Crew Members
BTRDA Asphalt Rally ChallengeNo
Driver Only
Co-Driver Only
Both Crew Members
The 2010 Legend Fires Get-Connected Epynt ChallengeNo
Driver Only
Co-Driver Only
Both Crew Members
The Richard Egger Insurance MSA Asphalt Rally ChampionshipNo
Driver Only
Co-Driver Only
Both Crew Members
The Steve Harkness Competition Tyres WAMC Tarmac ChampionshipNo
Driver Only
Co-Driver Only
Both Crew Members

Person to be contacted in case of serious accident to Driver

Name
Address   
Post Code
Telephone Number
Relationship
Will this person be attending the event?

Person to be contacted in case of serious accident to Co-Driver

Name
Address  
Post Code
Telephone Number
Relationship
Will this person be attending the event?

Seeding - Past Performance on Stage Rallies by Driver Only

We can only seed you on the information you supply - please give as much detail as possible

Event Name and ClubYearTypeSurfaceOverall PositionNo of Starters

Scrutineering

Sat 13th 15.00 -16.00
Sat 13th 16.00-17.00
Sat 13th 17.00-18.00
Sat 13th 18.00-19.00
Sun 14th 08.00-08.00 by previous arrangement ONLY
Participating in Recce? Yes
No

Fees - see above for how to pay

Entry Fee £

Port Talbot Motor Club Membership

£
Insurance£
Total Money to be sent £
Payment Method and Details

Entrant (if applicable and not driver)

Full Name
Address
Post Code
Telephone Number
Competition Licence Number

The details on this form will be held on computer in order to be used for the administration of this event. They will also be used to send you information about future events organised by this club, unless you untick this box to indicate you do not wish to receive information on further events.
The details on this form may also be passed on to other motorsport organisations, unless you untick this box to indicate you do not wish these details passed on.

Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry. Rejected entries and entries held in abeyance will be informed by e-mail to the address(es) given above.

By clicking on the "Enter the Rally" button below you agree to the following: "I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and, if any, the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the competition and the potential risk inherent with motor sport and agree to accept that risk. Further, I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through their negligence.."

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